Chelsea Recreation & Cultural Affairs

*CPS INTERNAL USE ONLY - Browne, Wright & Clark Schools Facility Request

Jul 10, 2023
submission #98
Reservation Form

Contact Person

Name/Last Name ---
Phone ---
Email Address ---
School Clark Avenue Middle School

EVENT INFORMATION

Event/Activity Name ---
Leader's Name ---
Brief Description of Event ---
School Building ---
Facility (please select all that apply) ---
Total Estimated Number of Participants 65
Do you require special equipment or setup? ---
Please specify Wi-Fi, tables and chairs set up for 65 people, screen and connection for PowerPoint presentations, and wireless mic.

Additional Questions

Will food be served? Yes

First Preference For Event Date

Is this event happening on one date or multiple dates? ---

First preference: Two or More Dates - Times

Dates (i.e. Every Sunday starting June 1 until September 1) ---
Times needed (i.e. 3-4:30pm) 3pm-5pm

Second Choice Interest: Two or More Dates

If your first choice dates are not available, do you have a second choice? ---
First Review by Recreation and Cultural Affairs

Decide which School should review this application:

Should Browne Principal review? No Browne Principal review necessary.
Should Wright Principal review? No, no Wright Principal review needed.
Should Clark Ave Principal review? Yes, Clark Ave Principal review needed.